The present invention relates generally to programming medical devices, and more particularly, to a system and a method for automatically verifying the medication to be infused into the patient.
Physicians and other medical personnel apply intravenous (“IV”) infusion therapy to treat various medical complications in patients. IV infusion therapy typically involves infusing medical fluids, such as drugs or nutrients, from a fluid supply, such as a bag, bottle, or other container, through the tube, or conduit, of a fluid administration set (“IV set”) to a cannula inserted into a patient's blood vessel. In a typical healthcare facility, a physician enters an order for medication for a particular patient. This order may be handled either as a simple prescription slip, or it may be entered into an automated system, such as a physician order entry (“POE”) system. The prescription slip or the electronic prescription from the POE system is routed to the pharmacy, where the order is filled. Typically, the prescribed medication is prepared by a pharmacist and added to a bag or bottle at a pharmacy. Under the supervision of a pharmacist the contents of the bag is identified with text on a paper label that is attached to the bag. This label may identify the contents of the bag by other means, such as a bar code, magnetic device or by use of a radio frequency (RF) signal interactive device such as an RFID tag, as examples. The prepared medication is then delivered to a nurse's station for subsequent administration to the patient.
For safety reasons and in order to achieve optimal results, the medical fluid is often administered in accurate amounts as prescribed by the doctor and in a controlled fashion by using an infusion pump. Infusion pumps operate by displacing the fluid from a fluid administration set to force fluid from the fluid supply through the tube and into the patient. The infusion pump is programmed by an operator such as a nurse or other medical personnel, with operating parameters to achieve the administration of the drug as prescribed by the physician. Such operating, or pumping, parameters are drug and patient specific. That is, the pumping parameters are selected based on the particular drug prescribed and the specific patient for whom they are intended. It is the nurse's responsibility to match the prescribed drug with the correct patient and with the properly programmed pump.
Healthcare facilities are concerned with providing safe medication systems in an era of nursing shortages and continually strive to provide quality patient care. Medical errors, such as when a patient receives the wrong drug or receives the correct drug at the wrong time or in the wrong dosage, are significant concerns for all health care facilities. In the administration of medication, focus is typically directed to the following five “rights” or factors: the right patient, the right drug, the right route, the right amount, and the right time. The nurse aims to ensure that these “rights” are all accomplished. Systems and methods seeking to reduce medical errors should also take these five rights into consideration.
Medical infusion pumps have advanced greatly over the years and permit more precise infusion control resulting in much better treatment for patients. Doctors are more assured that the doses and infusion rates that they prescribe for their patients can be delivered to the patients accurately by infusion pumps. The administration may be conducted in small discrete doses or may be given at an essentially continuous rate. Infusion pump therapy may be electronically controlled to deliver precise, metered doses at exactly determined levels, thereby providing a beneficial gradual infusion of medication to the patient. In this manner, the infusion pump is able to mimic the natural process whereby desired chemical balances are maintained precisely by operating on a continuous time basis. However, there remains a continuing concern that the right drug is matched to the right pump.
Certain manufacturers have created bar code systems designed to reduce the risk of intravenous medication errors by automatically programming the infusion system in an effort to increase the chances that the right drug goes to the right patient through the right pump. Such systems seek to eliminate the scenario of errors caused by clinicians incorrectly programming a pump by providing a system that automatically reads programming instructions and automatically programs the pump in accordance with those instructions. While some such systems can provide a significant benefit, others can involve considerable effort by the clinician to:                scan the bar code of the patient's identification device;        scan the bar code of the clinician's badge;        scan the bar code of the infusion system; and        scan the bar code of the IV medication container label;sometimes multiple times.        
A system is desired that accomplishes the objectives of a bedside bar code system but is more automated and requires less scanning of multiple bar codes. Those skilled in the art have recognized a need for a system that reduces the amount of time it takes to set up an infusion, and also provides the safety features that are the objectives of a bar code system. Unfortunately, some skill is required with a bar code system when it is working properly and when it is not working, information must be manually input to the appropriate medical devices by the clinician, with the attendant risk of typing or entry errors. Even when the bar code system is working properly, a clinician can mistakenly scan the label of another device that is in close proximity to the label he or she desires to scan, especially when the bar code scanner has a wide scan beam. When the bar code labels become wet with medical fluids, or are otherwise obscured due to one reason or another, they sometimes become unreadable by the bar code scanner then requiring the manual input of their information with its attendant risk of incorrect data entry.
There is the further problem of multiple fluid conduits where multi-channel pumps are involved. The same can occur where single-channel pumps are involved but many are mounted in close proximity to each other.
In some cases, a single patient may be prescribed multiple simultaneous infusions for different drugs, sometimes four or more, which requires multiple infusion pumps that may all be programmed differently. In such cases, there will also be multiple IV administration sets each with its own fluid conduit to be connected with the patient. Where there are multiple infusion conduits present, there is a concern that a fluid conduit may be mounted to the wrong infusion pump channel or wrong infusion pump and the drug delivered under incorrect pumping parameters. As an example, where multiple infusion pump channels are located side by side, there is a concern that a fluid infusion line or conduit may be installed in the wrong pump channel. Where a more dense infusion pump environment exists, it is important to be sure that the correct medical fluid conduits are being mounted to the correct pump or “channel.” The fluid sources for all pump channels may be suspended immediately above the pump channels and the conduits of the administration sets may become intertwined, thus making it more difficult to select the correct conduit for the particular channel of the pump.
Prior attempts have been made to assure that the right drug is administered to the right patient through the right pump. In one example, a bar code label identifying the drug and patient is applied to the bag at the pharmacy. After an operator such as a nurse manually programs the pump, a bar code scanner connected to the pump is used to read the bar code label on the bag to verify that it identifies the same medication as that programmed into the pump. In another example, U.S. Pat. No. 5,078,683 to Sancoff et al. discloses a bar code label applied to the bag that is read with a bar code scanner to automatically program the pump, thus avoiding manual programming entirely.
Even though the foregoing have provided significant advances in the art to avoid medication errors and have reduced the likelihood of such medication errors, there still exists some risk that an incorrect bag may become mounted to a pump or pump channel. Stated differently, there still exists some risk that a bag may become connected to the wrong pump or pump channel. For example, the nurse could possibly scan the bar code label of the correct bag, but become distracted and mount the conduit of the administration set connected to the bag to the wrong pump channel. Even if the nurse does not become distracted, the various fluid conduits in a multiple fluid infusion may be difficult to distinguish from one another and tracing the fluid conduit associated with the right bag may become burdensome, especially where the fluid conduits have become tangled with each other. In such a case, the nurse may inadvertently choose the wrong fluid conduit to install in the pump even after identifying the correct fluid supply.
Hence, those skilled in the art have recognized that a need still exists for a system and method to more accurately ensure that the correct fluids are infused into the patient at the correct pumping parameters. Further, those skilled in the art have recognized a need for a system and method that can more reliably determine that the correct fluid source is connected to the correct infusion pump or pump channel so that the fluid is infused into the patient in accordance with the correct pumping parameters. Additionally, those skilled in the art have recognized a need for a system that accomplishes the objectives of a bedside bar code system without taxing the clinician with the scanning of multiple bar codes. A need has also been recognized for a more automated system that provides for automatic infusion setup with the clinician only needing to verify the setup and then pressing the START key to begin infusion. A need has been recognized for providing accurate medical information to the correct device without the need for manually scanning labels or manually inputting information, yet is reliable and is cost effective to use. The present invention fulfills these needs and others.